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Distributed machine learning cloud teleophthalmology IoT for predicting AMD disease progression

Arun Das, Paul Rad, Kim-Kwang Raymond Choo, Babak Nouhi, Jonathan Lish, James Martel

Macular-Degeneration

Age-Related Macular Degeneration (AMD) Research using AREDS dataset provided by National Institute of Health (NIH).

Research Question: Developing Deep Learning algorithms for grading AMD into four severity categories.

Picture Ref: JAMA Severity Categories

Age-Related Macular Degeneration (AMD) Categories

Ref: ncbi.nlm.nih.gov

AMD Category 1.

Each eye has:

  • No drusen or small, nonextensive drusen
  • No intermediate drusen
  • No large drusen
  • No pigment abnormalities
  • No advanced AMD
  • A visual acuity score of 74 letters or more
  • No disqualifying lesions.

AMD Category 2.

At least one eye has one or more intermediate drusen, extensive small drusen, or pigment abnormalities associated with AMD, and neither eye has:

  • Large drusen
  • Advanced AMD
  • A visual acuity score of 73 or less
  • A disqualifying lesion.

AMD Category 3.

There are two types of AMD Category 3 participants.

  1. At least one eye has one or more of the following:
  • One or more large drusen
  • Intermediate drusen, with total drusen area
    • At least that of Circle I-2 (i.e., about 20 average-size intermediate drusen) if soft indistinct drusen are present or
    • At least that of Circle O-2 (i.e., about 1/5 disc area, or about 65 average-size intermediate drusen) if soft indistinct drusen are absent
  • Definite geographic atrophy not involving the center of the macula, and neither eye has any of the following:
    • Advanced AMD
    • A visual acuity score of 73 letters or less
    • A disqualifying lesion. or
  1. Only one eye meets the criteria specified above in part
  • and the fellow eye has either of the following:
    • A visual acuity score of 73 or less not attributable to AMD, or
    • A disqualifying lesion (listed in Section 3.1.3.2) considered to be uniocular.

AMD Category 4.

There are two types of AMD Category 4 participants.

  1. One eye has advanced AMD with or without visual acuity score of 73 or less, and with or without a disqualifying lesion considered to be uniocular, and the fellow eye has:
  • A visual acuity score of 74 or more
  • No evidence of advanced AMD
  • No disqualifying lesion. or
  1. One eye has reduced vision (< 74 letters) due to AMD, but no evidence of advanced AMD, and the fellow eye has:
  • A visual acuity score of 74 or more
  • No evidence of advanced AMD
  • No disqualifying lesion.

NIH AREDS Labelling Scheme

Ref: ncbi.nlm.nih.gov

  • Large Drusen: Large drusen (≥ 125 microns in diameter) in at least one eye at the last study visit and in at least one other study visit (in the same eye).
  • Large Drusen Questionable 1: Large drusen in at least one eye at 2 or more visits (other than the last visit).
  • Large Drusen Questionable 2: Large drusen in at least one eye only at the last study visit. This includes participants who only have a baseline visit if one or both eyes have large drusen.
  • Large Drusen Questionable 3: Large drusen in at least one eye at just one study visit (other than the last visit).
  • Control: AMD Category 1 (no drusen or small [< 63 microns in diameter] non-extensive drusen) in both eyes at all visits. This includes participants who only have a baseline visit if both eyes were graded as AMD Category 1.
  • Control Questionable 1: AMD Category 1 in both eyes at last visit and at all previous visits, except that one eye is AMD Category 2 (non-extensive intermediate [(≥ 63 microns to < 125 microns in diameter] drusen or extensive small drusen) at one visit.
  • Control Questionable 2: AMD Category 1 in both eyes at last visit and at all previous visits, except that each eye is AMD Category 2 at one visit.
  • Control Questionable 3: AMD Category 1 in both eyes at last visit, no worse than AMD Category 2 in either eye at all other visits, at least one eye is Category 2 at 2 or more visits prior to last visit.
  • Control Questionable 4: AMD Category 1 in one eye at last visit and AMD Category 2 in fellow eye at last visit; AMD Category 1 at all other visits. Participant must have at least one visit postbaseline.
  • Other, Non-control: Does not meet any of the criteria of categories noted above.